Meridian Senior Center Membership Signup BELONG

Meridian Senior Center Membership Signup

BELONG MEMBERSHIP
Type of registration*

New MemberRenew Membership
How did you hear about us?*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of birth*

MonthDayYear
Date
Are you a veteran?

YesNo
What Branch Did You Serve In?
Emergency Contact Information

Someone who doesn't live with you, if possible
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship to You*
Emergency Contact Phone Number*
Please enter a valid phone number.
I WANT TO RECEIVE EMAILS ABOUT TRIPS, EVENTS, ACTIVITIES, AND UPDATES

Yes
I AM INTERESTED IN PARTICIPATING IN THE FOLLOWING ACTIVITES

ArtBingoFoot ClinicDinners OutCards & Games (Pinochle, Bridge, Hand & Foot, Canasta, Farkle, Cribbage, etc.)Billiards/PoolKnitting/LoomingExercise ClassesDance ClassesInformational ClassesFinancial ConsultationTrips and OutingsSupport GroupsLegal ConsultationWoodworkingSpecial SpeakersBible StudyOther
I AM INTERESTED IN INFORMATION ABOUT VOLUNTEERING IN THE FOLLOWING AREAS

FundraisingGreetersNewsletter DeliveryBingoActivitiesLobby HostDiningClericalTeaching a ClassBoutiqueServe on the BoardCenter Event Planning
I WOULD LIKE MORE INFORMATION ABOUT THE CENTER'S TRANSPORTATION SERVICES

Yes
Please Read and Initial *Required

Per the Meridian Area Senior Citizens Association, Inc. Bylaws Article 4.4: It shall be the responsibility of each member to act in an appropriate manner; to refrain from obscene and profane language; and to respect the dignity of the members. Failure to do so shall result in disciplinary action and possible loss of membership, as determined by the Association Board. Conditions may be established from time to time by the Board of Directors and recorded in the minutes of the proceedings of the Board of Directors. The Board of Directors, by majority vote, has the sole authority to suspend or expel any member (General or Social) of the Association for violation of Association rules. ***General members live in Ada County. Social members live outside of Ada County or are a spouse under the age of 60 of a General member.
Initial Here*
Please Read and Initial *Required

Any person using any of the services, land, or facilities of Center at the Park/Meridian Senior Center, does so entirely at their own risk, and that Meridian Senior Center/Center at the Park is not liable for any personal injury, illness, personal property loss, or any other condition or effect that results directly or indirectly from use of the facility.
Initial Here*
Please Read and Initial *Required

By entering the Center at the Park/Meridian Senior Center, you are entering an area where photography, audio, and video recording will occur. By entering these premises, you consent to all recording of media and its release, publication, exhibition, and/or reproductions, to be used for any Meridian Senior Center/Center at the Park purpose. You further waive your rights to all claims in connection with any Center at the Park/Meridian Senior Center publication(s), regardless of its purpose.
Initial Here*
Please Read and Initial *Required

Attendance is not mandatory. Membership dues are used solely for operation and maintenance of Center at the Park/Meridian Senior Center.
Initial Here*
Your Electronic Signature *Required*

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Today's Date*

MonthDayYear
Date
Age Verification *Verify you are over 60 years of age*

YesNo
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Meridian Senior Center Membership Signup

Emergency Contact Information

Please Read and Initial *Required

Please Read and Initial *Required

Please Read and Initial *Required

Please Read and Initial *Required